Friday, November 27, 2009

Our Pregnancy and Parenting Support Network had it's final get together for 2009. It has been a fantastic year with our network growing. Any where up to 30 people come along (plus lots of babies and toddlers) to share experiences, information and support. I personally am looking forward to our next get together in 2010.

Curbed midwives push to break free

Sydney Morning Herald

JULIE ROBOTHAM HEALTH EDITOR

November 9, 2009

MIDWIVES' ability to work independently - promised by the federal Health Minister, Nicola Roxon - would depend on endorsement by individual doctors under an amendment to proposed legislation that has infuriated women's groups.

Birth advocacy groups will rally today at sites across the country, including the Brisbane headquarters of the Prime Minister, Kevin Rudd, and in Sydney outside the Surry Hills office of the Minister for the Status of Women, Tanya Plibersek, to protest at the amendment, made public last week, which reveals that to work in private practice midwives will first have to ''enter a collaborative arrangement … with one or more medical practitioners''.

Critics say the Government has capitulated to doctors and the move undermines the intent of a series of bills before the Senate, which for the first time would allow midwives' clients to claim a Medicare rebate for their services.

It also threatens rural women's access to birth services, they say, and puts midwives at the mercy of sometimes hostile doctors for their professional registration, Medicare funding and indemnity insurance.

Hannah Dahlen, vice-president of the Australian College of Midwives, said the decision tied midwives' ability to practise ''to the sign-off as a doctor'' - contradicting the World Health Organisation's definition, which describes a midwife as an ''accountable professional [who can] conduct births on the midwife's own responsibility''.

Midwives accepted the need to collaborate, she said, but should be required to have working relationships with health services rather than individual doctors.

''There are particular issues in rural and remote Australia where sometimes there is no doctor, or no permanent doctor, just three-month locums,'' Associate Professor Dahlen said. ''This is not about safety, not about evidence. It's purely about politics. Collaboration's about mutual trust and respect. It's not about one profession choosing when another will or won't work.''

Professor Dahlen said the amendment could prevent new models of pregnancy and birth care envisioned in the law reform - such as midwives working in a group practice - from getting off the ground.

When she announced midwives would be given Medicare rights, Ms Roxon said the $67 million measure would ''improve the flexibility of the health workforce'' and allow patients better access to services.

The amendment is also likely to threaten women's ability to choose to give birth at home, if midwives cannot find a doctor to support them in such births.

Doctors groups - including the Australian Medical Association, which is understood to have campaigned hard for the amendment, and obstetricians' representatives - have been vocal in their opposition to home birth, saying it is unsafe.

Under current rules, midwives can manage home births but are not insured to do so and must disclose this to women. The new law would end this.

Alison Leemen, assistant co-ordinator of Homebirth Access Sydney, said the Government had ducked a potentially furious debate about doctors' veto over midwives.

Please find at the bottom of this Newsletter a media statement for Nicola Roxon regarding a Midwives/Nurse Practitioner Amendment. The point that will redefine the fundamental nature of midwifery and certainly homebirth midwifery in Australia is that “collaborative arrangements with medical practitioners will be required to access the new arrangements”. In short this amendment will require midwives to work with GP obstetricians and private obstetricians and have a “collaborative arrangement” in place at all times.

This is NOT acceptable. How will it be possible for a midwife who attends homebirths and for women wishing to birth at home to gain the support of a GP ob or private obstetrician when their own college statement does not support homebirth?

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) statement reads -“The College does not support Home Birth or ‘Free-standing’ Birth Centres (without adjacent obstetric and neonatal facilities) as appropriate Health Care Settings. The College acknowledges that a very small minority of women will choose to birth in these centres, even if appropriately informed of the consequences”

In solidarity with our northern and southern sisters (who will be rallying outside Kevin Rudd’s Brisbane office and Julia Gaillard’s Melbourne office) please come and rally outside the Minister for the status of women, Tanya Plibersek’s office in Sydney.

We need this to be as big as possible. We invite other groups to join the rally to make this the beginning of a very clear election campaign.

Politicians need to understand that we have a very big problem and we are not going to go away. We have tried writing submissions, protesting in Canberra, contacting the health minister Nicola Roxon by phone and email, but she is not listening.

Our message:My Birth, My Choice

We are:Women, children, men, families, friends who support choice in birth, including homebirth with a private midwife.

Bring:Bring banners, drums and percussion instruments. Let’s make sure we are seen and heard!!Bring a 'calling card' to drop off, letting our Minister for the status of women know that women want choice in childbirth and this includes the choice to hire a private midwife to birth at home (or in hospital). The calling card should be an A4 piece of paper (can be larger or smaller) with your name and address, concerns, experience, suggestions and a request for a response from Tanya Plibersek about this important issue.

Rally organisers:The rally is being organised by Homebirth Australia and is supported by Maternity Coalition.More info -

The Minister for Health and Ageing, Nicola Roxon has today circulated an amendment the Government intends to introduce into the Health Legislation (Midwives and Nurse Practitioners) Bill and the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill.

This amendment makes clear in the legislation something that was articulated both on introduction of the Bill to parliament and in the explanatory material tabled at that time.Following requests for clarification, this amendment will simply clarify in legislation that collaborative arrangements with medical practitioners will be required to access the new arrangements.

The details of these requirements will be specified in subordinate legislation following the ongoing consultation with the professional groups.

These bills are a key plank of the Government’s 2009/10 Budget commitments which recognises for the first time the role of appropriately qualified and experienced midwives and nurse practitioners in our health system.

The Minister for Health and Ageing said today “I thank the doctors, nurses and midwives for their constructive engagement to date to ensure these new opportunities for nurses and midwives are implemented in an integrated fashion for the benefit of patients.”

About Me

In 1989 the birth of my first child was the start of my passion for pregnancy, birthing and babies. Initially I campaigned for improvement in maternity services as a consumer and became a childbirth educator running prenatal classes in the community. In 1991 I commenced studying at university completing a degree in nursing and followed by a graduate diploma in midwifery. I founded my business Pregnancy, Birth and Beyond in 1992. Registering as a midwife in 1997, I began working on a team midwifery program in a tertiary hospital and moved into private midwifery practice in 1999. Today, primarily, I support women birthing at home. I am passionate about midwives moving away from the hospital system and commencing private practice. It is through private midwifery practice that women will truly have continuity of care and real options for birth open to them. Part of my work now is supporting midwives taking the step into private practice. I also continue to be politically active lobbying for the rights of pregnant women and their families. I've dedicated my life to supporting families, as they move through the childbearing year.